Correlation Between TCM Syndrome Types And Bone Metabolism Indexes In Type 2 Diabetes

Objective:Collect basic information on patients with type 2 diabetes,including general information,bone metabolism indicators and other laboratory indicators,and conduct TCM syndrome differentiation,analyze and evaluate the correlation between different TCM syndrome types and bone metabolic markers in type 2 diabetes,provide a reference for clinical diagnosis and treatment.Methods:The medical records of 296 T2 DM hospitalized patients who met the diagnostic criteria were selected,the database was established,the relevant data was entered into the data table,and the SPSS statistical software was used to compare the differences of bone metabolism and other indicators among patients with different TCM syndrome types,and to analyze the correlation of TCM syndromes and bone metabolism indicators.Results:(1)A total of 296 subjects were enrolled in the study,including 56 cases of yin deficiency and internal heat syndrome,79 cases of qi and yin deficiency syndrome,68 cases of spleen deficiency and dampness syndrome,and 93 cases of yin and yang deficiency syndrome.(2)In terms of gender composition ratio,there was no significant difference in gender composition ratio between the four syndrome types(P =.749>0.05 by chi-square test).(3)In terms of age and duration,there were obvious differences among the four types of syndromes(P<0.01),with an average age of 67.84±13.70 years and an average duration of 11.47±5.16 years.The age and duration of the disease are all yin and yang deficiency syndrome> spleen deficiency and dampness syndrome> Qi and yin deficiency syndrome>Yin deficiency internal heat syndrome.(4)The comparison of laboratory indicators shows:The comparison of Bone Gla-protein(BGP),vitamin D and Alkaline phosphatase(ALP)in the four syndrome patients was statistically significant,and the correlation with syndrome differentiation was obvious.There were no statistically significant differences among the other four types of syndromes.The fasting blood glucose(FBG)and Glycosylated Hemoglobin(HBA1c)of the four syndrome patients were significantly different(P=0.000<0.01).There were significant differences in the triglyceride(TG)(P=0.038<0.05)and Total Cholesterol(TC)(P=0.000<0.01)among the four syndrome patients,and the overall trend of the indicators was Yin deficiency heat syndrome>qi and yin deficiency syndrome> spleen deficiency and dampness syndrome> yin and yang deficiency syndrome.There were no significant differences in Cystatin C(Cys-c)between the four syndrome types.(5)The correlation between glucose metabolism index bone metabolism index and analysis shows:Among patients with yin deficiency and internal heat syndrome,FBG and HBA1 c were negatively correlated with BGP,and the regression equation of HBA1 c and BGP was established.FBG,HBA1 c and ALP were negatively correlated in patients with yin deficiency syndrome.In patients with spleen deficiency and dampness syndrome,HBA1 c was negatively correlated with BGP,and the regression equation was established.Among the patients with Qi and Yin deficiency syndrome,HBA1 c was significantly positively correlated with Parathyroid hormone(PTH)(P<0.01),and the regression equation was established.FBG and HBA1 c were negatively correlated with Type I collagen amino peptide(PINP),and the regression equation of HBA1 c and PINP was established.In patients with yin and yang deficiency syndrome,HBA1 c was significantly positively correlated with calcium(calcium,Ca)(P<0.01),and the regression equation was established.(6)Correlation between lipid metabolim and bone metabolsm index and egression analysis shows:Among patients with yin deficiency and internal heat syndrome,Ca was positively correlated with TG and TC.In patients with spleen deficiency and dampness syndrome,Ca was positively correlated with TG and TC,and the correlation with TG was significant(P<0.01),and the regression equation was established.There was a significant positive correlation between Ca and TC in patients with yin and yang deficiency syndrome(P<0.01),and the regression equation was established.In the overall patient,Ca was significantly positively correlated with TG and TC(P<0.01),and the regression equation with TC was established.It can be seen that Ca is most sensitive to lipid metabolism.In addition,the TC of patients with yin and yang deficiency syndrome was significantly positively correlated with BGP,PINP,β-CTX,and Ca(P<0.01),and TG and TC were negatively correlated with vitamin D.The bone metabolism of this syndrome has the greatest impact on lipid metabolism.The correlation between TG and PTH is more significant.There was a negative correlation between TG and PTH in patients with yin deficiency and heat syndrome and spleen deficiency and dampness syndrome,and the regression equation was established.(7)Correlation and regression analysis of Cystatin C(Cys-c)and bone metabolism indicators shows:Among the patients with Qi and Yin deficiency syndrome,Cys-c was negatively correlated with BGP,and the regression equation was established.Cys-c was positively correlated with Ca in patients with spleen deficiency and dampness syndrome(P<0.01),and the regression equation was established.There was a significant negative correlation between Cys-c and ALP in the overall patients and patients with yin and yang deficiency syndrome(P<0.01),and the regression equation was established.It can be seen that Cys-c mainly affects bone formation and acts on bone metabolism,and the correlation between Cys-c and ALP is stable.Conclusion:(1)There were no significant differences in gender between the four types of syndromes.The age and duration of disease were ranked as follows: yin and yang deficiency syndrome> spleen deficiency and dampness syndrome> Qi and yin deficiency syndrome> Yin deficiency internal heat syndrome.(2)Patients with yin deficiency and internal heat syndrome mainly cause bone detruction disorder,and patients with yin and yang deficiency syndrome mainly cause insufficient bone formation.(3)The correlation between BGP,vitamin D and ALP and TCM syndrome fferentiation is obvious.(4)FBG and HBA1 c in patients with yin and yang deficiency syndrome are the highest among the four types of syndrome patients,and they must actively control blood sugar.(5)The lipid metabolism index(TG,TC)of patients with yin and yang deficiency syndrome was the lowest among the four syndrome types,but the bone metabolism index was more affected by lipid metabolism than the other three syndrome types,and it still needs to actively control blood lipids.(6)FBG and HBA1 c mainly affect bone formation,but the correlation between HBA1 c and bone metabolism is more obvious,and it is more stable than FBG.It can be seen that patients with type 2 diabetes need to control blood sugar fluctuations.(7)Lipid metabolism has a significant effect on Ca.And lipid metabolism index is positively correlated with Ca,which may be related to its influence on bone destruction and promotion of blood calcium into blood.(8)Cys-c may act on bone metabolism by affecting bone formation.(9)In all patients,the correlation between HBA1 c and BGP,TG and PTH,Cys-c and ALP was stable.